Multiple Myeloma

Myeloma is a type of cancer that begins in plasma cells (white blood cells that produce antibodies), which is also called Kahler disease, myelomatosis, and plasma cell myeloma. Multiple myeloma and other plasma cell neoplasms are diseases in which the body makes too many plasma cells.

Plasma cells develop from B lymphocytes (B cells), a type of white blood cell that is made in the bone marrow. Normally, when bacteria or viruses enter the body, some of the B cells will change into plasma cells. The plasma cells make a different antibody to fight each type of bacteria or virus that enters the body, to stop infection and disease.

Plasma cell neoplasms are diseases in which there are too many plasma cells, or myeloma cells, that are unable to do their usual work in the bone marrow. When this happens there is less room for healthy red blood cells, white blood cells, and platelets. This condition may cause anemia or easy bleeding, or make it easier to get an infection. The abnormal plasma cells often form tumors in bones or soft tissues of the body. The plasma cells also make an antibody protein, called M protein, that is not needed by the body and does not help fight infection. These antibody proteins build up in the bone marrow and can cause the blood to thicken or can damage the kidneys.

 

Staging of Multiple Myeloma:

 

Stage I: In stage I multiple myeloma, the blood levels are as follows:

  • beta-2-microglobulin level is lower than 3.5 g/mL; and
  • albumin level is 3.5 g/dL or higher.

Stage II: In stage II multiple myeloma, the blood levels are as follows:

  • beta-2-microglobulin level is lower than 3.5 g/mL and the albumin level is lower than 3.5 g/dL; or
  • beta-2-microglobulin level is as high as 3.5 g/mL but lower than 5.5 g/mL.

Stage III: In stage III multiple myeloma, the blood level of beta-2-microglobulin is 5.5 g/mL or higher.

The stages of other plasma cell neoplasms are different from the stages of multiple myeloma.

Isolated plasmacytoma of bone: In isolated plasmacytoma of bone, one plasma cell tumor is found in the bone, less than 5% of the bone marrow is made up of plasma cells, and there are no other signs of cancer.

Extramedullary plasmacytoma: One plasma cell tumor is found in the soft tissue but not in the bone or the bone marrow.

Macroglobulinemia: There is no standard staging system for macroglobulinemia.

Monoclonal Gammopathy of Undetermined Significance: In monoclonal gammopathy of undetermined significance (MGUS), less than 10% of the bone marrow is made up of plasma cells, there is M protein in the blood, and there are no signs of cancer.

 

Treatment: of Myeloma:

 

There are different types of treatment for patients with multiple myeloma and other plasma cell neoplasms. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials.

The following treatments are used for myeloma: chemotherapy, other drug therapy, corticosteroid therapy, thalidomide and lenalidomide, targeted therapy, high-dose chemotherapy with stem cell transplant, biologic therapy, radiation therapy, surgery, watchful waiting, plasmapheresis, supportive care and new combinations of therapies.

 

Clinical trials are studying different combinations of biologic therapy, chemotherapy, steroid therapy, and drugs such as thalidomide or lenalidomide. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice.

Search for clinical trials in Georgia.

Adapted from the National Cancer Institute's PDQ Database: http://www.cancer.gov/cancertopics/pdq/treatment/myeloma/patient. (Accessed July 2016)